Home            Past Issues            About IP            About IAP           Author Information            Subscription            Advertisement              Search  

   
Correspondence

Indian Pediatr 2017;54: 783

Simultaneous Two Site Blood Culture in Diagnosis of Neonatal Sepsis: Few Concerns

 

Jogender Kumar and *Amitabh Singh

Department of Pediatrics, Chacha Nehru Bal Chikitasalay, New Delhi, India.

Email: [email protected]

   


We read with interest the recent research paper by Tomar, et al. [1] in Indian Pediatrics. We have following comments and queries:

1. In the present study, authors mentioned that there was no polymicrobial growth in any of the cultures; what was the reason for this finding? Most of the studies in neonates report a frequency of 4% to 25% polymicrobial infections out of all bloodstream infections [2,3].

2. The results of this study differ from study by Sarkar, et al. [4], and author attributed it to small sample size and inclusion of inborn babies only in the study; however, to us it seems more due to gross differences in rates of culture positivity in two studies (9.2% vs 46%).

3. In the present study, incidence of candidemia was very high (one-third of total culture positive infections); is there any peculiarity in the study population for this heterogeneous result?

4. Although sending two blood cultures simultaneously improves diagnostic yield, it will add cost to patient care, demands more manpower, and will cause more pain to neonate. The problem of false positivity can be overcome by time to positivity (TTP) of blood culture. Various studies have given time to positivity for individual class of organism beyond which it can be considered as contaminant [5].

References

1. Tomar P, Garg A, Gupta R, Singh A, Gupta NK, Upadhyay A. Simultaneous two site blood culture in diagnosis of neonatal sepsis. Indian Pediatr. 2017;54:199-203.

2. Pammi M, Zhong D, Johnson Y, Revell P, Versalovic J. Polymicrobial bloodstream infections in the neonatal intensive care unit are associated with increased mortality: A case-control study. BMC Infect Dis. 2014;14:390.

3. Hall KK, Lyman JA. Updated review of blood culture contamination. Clin Microbiol Rev. 2006;19:788-802.

4. Sarkar S, Bhagat I, DeCristofaro JD, Wiswell TE, Spitzer AR. A study of the role of multiple site blood cultures in the evaluation of neonatal sepsis. J Perinatol. 2005;26:18-22.

5. Biondi EA, Mischler M, Jerardi KE, Statile AM, French J, Evans R, et al.;for the Pediatric Research in Inpatient Settings (PRIS) Network. Blood culture time to positivity in febrile infants with bacteremia. JAMA Pediatr. 2014;168:844-9.


 

Copyright © 1999-2017 Indian Pediatrics